| NPI | 1588744650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036141794) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 232845) |
| 207R00000X Internal Medicine (Licence: FL ME118086) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-11-06 |